• Vladimir Kalousek, Tomislav Sajko, Bruno Splavski, Krešimir Rotim, Mia Jurilj, Branimir Čulo, and Ante Rotim.
• 1Department of Radiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 3University of Applied Health Sciences, Zagreb, Croatia; 4Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 5Josip Juraj Strossmayer University of Osijek, Faculty of Dental Medicine and Health, Osijek, Croatia; 6Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia.
• Acta Clin Croat. 2020 Dec 1; 59 (4): 754-760.

AbstractInfected intracranial aneurysms are a rare type of inflammatory vascular lesions that occur due to infection of intracranial arterial wall. Brain aneurysms of distal arterial branches are equally rare and frequently multiple, including those situated at the peripheral middle cerebral artery segments. Although both types represent a small percentage of all intracranial aneurysms, they may bring about high mortality in case of rupture. The management of such aneurysms includes conservative treatment with broad-spectrum antibiotics, and microsurgical or endovascular treatment, which is gaining more prominence for both asymptomatic and ruptured aneurysms. Herein, we present a case of a 61-year-old male patient with a history of cardiac infective disease and multiple bilateral aneurysms of infected distal branch middle cerebral arteries, discussing the efficacy of available endovascular treatment modalities and reviewing the literature. In conclusion, selective endovascular coiling is a preferable method in the current management of distal branch infected ruptured intracranial aneurysms, which may bring a favorable outcome.

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